Evolution of renal function in patients with primary hyperparathyroidism submitted to parathyroidectomy

Financial support: None. Conflicts of interest: No conflicts of interest declared concerning the publication of this article. Submitted: July 06, 2017. Accepted: December 05, 2017. The study was carried out at Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina, Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, São Paulo, SP, Brasil. Abstract Introduction: Primary hyperparathyroidism (PHPT) is a hypercalcemic disorder resulting from inappropriate parathyroid secretion (PTH). The surgical treatment is considered the mainstay of therapy. Several studies have observed the worsening of renal function in these patients after parathyroidectomy (PTX), however, the pathophysiology of this phenomenon is unknown. Objective: The purpose of this study is to describe the postoperative renal function in patients with PHPT operated at the Federal University of São Paulo UNIFESPbetween the years 2007 and 2016, evaluating the risk factors for renal function decline. Materials and Methods: This is a cohort study. A total of 142 patients were divided into two groups according to their renal function: Group I (> 60 mL / min / 1.73 m2) and Group II (<60 mL / min / 1.73 m2). Results: Increased serum creatinine was observed in both groups in the first 96 hours, with partial recovery over the first month. Creatinine values> 1.82 mg / dL in patients with renal disease are associated with worse prognosis for renal function after surgery and PTH values> 400 pg / dL are associated with a poor renal outcome, independent of previous renal function. Conclusion: Patients with elevated baseline PTH and creatinine had a worse outcome of renal function one year after surgery